High profile round 375cc submuscular, is this too big for small 50kg, 163cm chest measuring 11.5cm?

Question

Hi there, I'm a small super fit 50kg , 163cm and measure 11.5cm I've had 3 children and due to breast feeding and running I have no breast (size a cup) Tried on the 340 and 375 and was opting for the 375. I've heard 99% of woman after surgery wishes they'd gone bigger. I'm 42 and do t want to regret not getting bigger but will it affect my running etc? Plus will it look too much of tasteful for my measurements? Thanks

Keith Hodge, MD · Answer

This often a difficult decision for women, what size? Hopefully you have tried on sizers to help with the decision making process. I use Natrelle Inspira implants, so with an 11.5 cm breast width, I would suggest an ultra high profile implant if 375 cc's is the goal. It is 11.25 cm's in diameter. For a high or full profile I would suggest the 295 cc (11.25 cm) or the 325 cc (11.40 cm) implant. I don't think that an implant will affect your running. Good luck!

Terrence Scamp, MBBS, FRACS · Answer

Hello there The most accurate way to get an idea of post-operative breast size is to do an imaging session with a Vectra 3D .Combining this with a sizer kit you should get a very good idea .The difference between 340 and 375 is barely perceptible so if you like one you will probably like the other . Definitely not worth stressing about .CheersTS

Farah Naz Khan, MD · Answer

Hard to answer this without an in person exam and specific breast measurements (and not just your height/weight and breast width!). Remember also that there is no direct correlation between implant size (cc's) and cup size. Best option is to choose a board certified plastic surgeon who actually takes the time to measure you and examine your breast pocket. Sizers will only give you a rough estimate. The goal of breast augmentation is to optimally fill your breast pocket, not to overstuff or understuff it. At my practice, we utilize a series of 5 breast measurements that help me determine the ideal implant size, which in turn helps me deliver a 24 hour recovery. Do your research and choose a surgeon who takes the time to sit down with you and discuss your goals/expectations to determine the best size for you. Good luck!!

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  Photographs would also be helpful.   The size, profile, and shape of
the implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Daniel Barrett, MD · Answer

Dear 40s,determining the ideal breast size and matching that goal for the patient is the most difficult part of breast augmentation. It starts and ends with the patient. We have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements. Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If its too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match. Of all of my breast augmentation patients, everyone of them have been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question!
  
After performing hundreds of breast augmentations, I have found that the size of implant best for you is dictated by your chest wall measurements. Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance. Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision. Bringing photos as well can help us to finalize, but please understand that these are of other people’s bodies and your results will probably be different.
  
Silicone will give you fullness at the top (upper pole fullness). Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a softer silicone (less cross-linked), if this implant should rupture, it may leak but only into the scar capsule formed. However, the newer silicone in these implants may not leak even when the implant shell is ruptured.
  
Anatomic gummy bear implants might be a good choice to give you a more natural look. These highly sought after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, is a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.
  
During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers. I also use a 3D imaging system to allow you to try on a variety of shapes and sizes. I prefer this method over adding volume due to implants being under the muscle.
  
We will also discuss the possibility of needing a lift along with an implant. This will depend on the amount of ptosis (nipple position) as it relates to your breast, inframammary crease and chest wall. Needing a lift or not will also determine where to place the scar for the incision.  In some cases if the breast and nipple is really ptotic (low) it might be best to stage the procedure by performing a lift first and then doing an implant at a second stage. This will also allow you to have a better understanding of the true size and shape of your breast.
  
The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.
  
Best of luck!
  
Dr. Schwartz
  
Board Certified Plastic Surgeon 
  
#RealSelf100Surgeon
  
#RealSelfCORESurgeon

Carmen C. Munteanu, MD, FRACS · Answer

Thank you for the question!
It sounds that you have tried a few things and you did your homework right!
Make sure you try sizers and also the rice bags, they can be very useful, as you wear them and you can see yourself in a few mirrors and positions!
Mind you, not sure if you can see the difference between 340 and 375, probably easier to think- bigger or smaller?
And make sure you trust your surgeon, and you discussed long enough to establish a good connection and they are working in your best interest!
What I do in theatre is that I try different sizers and I then chose based on my patient's wishes!
Take care, good luck!!

Tom J. Pousti, MD · Answer

Thank you for the question. My best advice: more communication.
It is definitely worth spending more time (prior to the date of surgery) with your plastic surgeon to discuss further.  As you know, it will be important for many reasons, that you feel comfortable that you and your plastic surgeon are on the "same page" prior to proceeding.

There are several steps taken to select a specific size/profile breast implant for a specific patient. These steps will vary from one practice to another.  I prefer to have a wide selection of implants (all profiles) available in the operating room. I use intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison. I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible. 
Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.
Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “natural” or "C or D cup” or "tasteful" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.
 
I hope this helps. Best wishes for an outcome that you will be very pleased with.

David A. Sieber, MD, FACS · Answer

Thanks for the great question. Selecting an implant will be the most difficult thing you have to do prior to surgery. The difference between a 340 and a 375 is less than a shot glass. Don't get too stuck on the numbers. Instead, let your surgeon know what type of look you want and work with them to find the right implant. A 340 will give you a little more natural look while a 375 may be a little more augmented look. I always suggest patients find photos of other women their size on line to see what size implants they have. Each implant is going to look totally different in different patients. Best of luck!~Dr. Sieber

Brooke R. Seckel, MD, FACS (retired) · Answer

Congratulations on your upcoming breast augmentation.  The 375 cc high-profile breast implants should give you an absolutely beautiful result and you will likely be a D cup at Victoria secret and a full C cup at other retailer's.  Moving on to 400 cc as a significant larger step and as a runner I would not recommended.

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